Chronic Venous Insufficiency: An Unusual Cause of Ankle Pain Presenting with Periosteal Reaction

Chun-Hsien Huang, Ming-Tung Huang and Cheng-Li Lin

Department of Orthopedic Surgery, Show Chwan Memorial Hospital, Taiwan Department of Orthopedics, National Cheng Kung University Hospital, Taiwan Medical Device R&D Core Laboratory, National Cheng Kung University Hospital, Taiwan

^*Correspondance to: Cheng-Li Lin 

 PDF  Full Text Case Report | Open Access

Abstract:

This is an uncommon case of ankle pain caused by chronic venous insufficiency which presented with periosteal reaction. The case is a 70-year-old woman with a medical history of hypertension and lung cancer. She came to our clinic for right ankle pain. X-rays revealed a periosteal reaction along the right distal tibia and fibula region. MRI showed non-specific infiltration and edema in the soft tissue around the ankle. Multiple lamellar depositions on the periosteum as an onion-feature were also found. Considering the clinical symptoms and the image findings, it was agreed that venous insufficiency induced the periosteal reaction. The causes of the periosteal reaction are broad and include tumors, trauma, infections, arthritis, drugs, or vascular problems. It is also known to be associated with CVI, but the exact pathophysiology is still unknown. This report aims to remind clinical physicians to be aware of such a rare cause and presentation of ankle pain.

Keywords:

Chronic venous insufficiency; Venous insufficiency; Periosteal reaction; Ankle pain; Periosteum

Cite the Article:

Huang C-H, Huang M-T, Lin C-L. Chronic Venous Insufficiency: An Unusual Cause of Ankle Pain Presenting with Periosteal Reaction. Ann Clin Case Rep. 2020; 5: 1869..